TY - JOUR
T1 - Primary patency with stenting versus balloon angioplasty for arteriovenous graft failure
T2 - A systematic review and meta-analysis
AU - Marmagkiolis, Konstantinos
AU - Iliescu, Cezar
AU - Edupuganti, Mohan Mallikarjuna Rao
AU - Saad, Marwan
AU - Boudoulas, Konstantinos Dean
AU - Gupta, Akash
AU - Lontos, Nikolaos
AU - Cilingiroglu, Mehmet
N1 - Publisher Copyright:
© 2019 HMP Communications. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Objectives. To evaluate the efficacy of advanced stent technology in the management of failing arteriovenous grafts (AVGs). Background. End-stage renal disease rates and the need for hemodialysis are increasing worldwide. AVG remains a common dialysis access site. Several techniques have been previously suggested to restore and preserve AVG patency. A quantitative evaluation and synthesis of this information are essential in elucidating the role of newer stent platforms for the management of failing AVG. Methods. We performed a literature search using PubMed, Web of Science, and Embase from January 2006 to December 2017. Studies comparing the primary patency rates with stent placement vs balloon angioplasty alone in patients with failed AVGs were included. Results. Seven studies with a total of 1109 patients met the inclusion criteria. The mean graft age was 2.89 years in the stent group and 3.29 years in the balloon angioplasty group. Stent placement was associated with improved primary patency rates compared with balloon angioplasty alone at short-term (3-month) follow-up (73.2% vs 42.6%, respectively; risk ratio [RR], 0.55; 95% confidence interval [CI], 0.35-0.88; P=.01) and mid-term (6-month) follow-up (50.8% vs 18.4%, respectively; RR, 0.65; 95% CI, 0.51-0.82; P<.001). The primary patency rates remained favorable with stent placement at 12-month (40.3% vs 13.0%, respectively; RR, 0.69; 95% CI, 0.63-0.77; P<.001) and 24-month follow-up (20.5% vs 6.8%; RR, 0.86; 95% CI, 0.80-0.92; P<.001) compared with balloon angioplasty alone. Conclusions. Stent placement is associated with improved patency rates compared with balloon angioplasty alone.
AB - Objectives. To evaluate the efficacy of advanced stent technology in the management of failing arteriovenous grafts (AVGs). Background. End-stage renal disease rates and the need for hemodialysis are increasing worldwide. AVG remains a common dialysis access site. Several techniques have been previously suggested to restore and preserve AVG patency. A quantitative evaluation and synthesis of this information are essential in elucidating the role of newer stent platforms for the management of failing AVG. Methods. We performed a literature search using PubMed, Web of Science, and Embase from January 2006 to December 2017. Studies comparing the primary patency rates with stent placement vs balloon angioplasty alone in patients with failed AVGs were included. Results. Seven studies with a total of 1109 patients met the inclusion criteria. The mean graft age was 2.89 years in the stent group and 3.29 years in the balloon angioplasty group. Stent placement was associated with improved primary patency rates compared with balloon angioplasty alone at short-term (3-month) follow-up (73.2% vs 42.6%, respectively; risk ratio [RR], 0.55; 95% confidence interval [CI], 0.35-0.88; P=.01) and mid-term (6-month) follow-up (50.8% vs 18.4%, respectively; RR, 0.65; 95% CI, 0.51-0.82; P<.001). The primary patency rates remained favorable with stent placement at 12-month (40.3% vs 13.0%, respectively; RR, 0.69; 95% CI, 0.63-0.77; P<.001) and 24-month follow-up (20.5% vs 6.8%; RR, 0.86; 95% CI, 0.80-0.92; P<.001) compared with balloon angioplasty alone. Conclusions. Stent placement is associated with improved patency rates compared with balloon angioplasty alone.
KW - Balloon angioplasty
KW - Renal disease
KW - Stent
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M3 - Article
C2 - 31786526
AN - SCOPUS:85075913131
SN - 1042-3931
VL - 32
SP - E356-E361
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 12
ER -